Departament de Filologia Anglesa i Alemanya
PhD Program: “Oralitat i escriptura: llenguatges especialitzats dins de l’àmbit anglo-germànic”
A GENRE APPROACH TO ELECTRONIC RAPID RESPONSES FROM THE ONLINE BRITISH MEDICAL JOURNAL
Doctoral Thesis Submitted by Ingrid Carolina Garcia Ostbye
Supervised by: Dr. Barry Pennock Speck Dr. Jordi Piqué i Angordans
2015
Departament de Filologia Anglesa i Alemanya
PhD Program: “Oralitat i escriptura: llenguatges especialitzats dins de l’àmbit anglo-germànic”
A GENRE APPROACH TO ELECTRONIC RAPID RESPONSES FROM THE ONLINE BRITISH MEDICAL JOURNAL
Doctoral Thesis Submitted by Ingrid Carolina Garcia Ostbye
Supervised by: Dr. Barry Pennock Speck Dr. Jordi Piqué i Angordans
2015
Acknowledgements
I would like to express my deepest gratitude to Dr. Barry Pennock-Speck and Professor Jordi Piqué i Angordans. This work is due to a great extent to their excellent knowledge of the keys to stimulate postgraduate researchers’
motivation, their academic support and their persistent encouragement during the process of writing this dissertation. I would also like to thank them for their efforts at guiding and supporting me personally in the difficult and decision making times during the writing of this dissertation and for their constructive criticism. During the talks that we held they provided counsel and thought- provoking comments to my ideas on this subject.
Special thanks are extended to Professors Ingar Roggen and Stein Brảten for their invitation to attend a seminar on social informatics at the University of Oslo (Norway) and also for providing me with deep insights in the field of sociology of knowledge and communication, which have contributed to the relativization framework of this study.
Thanks are extended to David Conesa Guillen and Ramon Camaño Puig for their counsel in the methodogical aspects in this thesis.
My thanks also go to Manuel Garcia Roggen from the Universitat de València for his expert help in the field of medicine and to Mila San Luis Blasco from the Universitat de València for her support.
care and love during these years.
Socrates: ... Then medicine also treats of discourse?
Gorgias: ... Yes.
Plato1
1Gorgias By Plato Written 380 B.C.E. Translated by Benjamin Jowett http://classics.mit.edu/Plato/gorgias.html
Table of Contents
Index of Tables ... xvi
Index of Figures ... xvii
Index of Acronyms ... xix
Thesis Summary ... xxi
Chapter 1. Introduction ... 1
1.1 General aim of the thesis ... 3
1.2 Rationale for the research ... 6
1.3 Background to the thesis ... 9
1.3.1 The e-Health Revolution ... 9
1.3.2 The British Medical Journal ... 10
1.3.3 The British Medical Journal review policy... 14
1.3.4 Open Post Publication Review Debates ... 17
1.4 Electronic Rapid Responses to online genres ... 24
1.5 Objectives of the thesis ... 31
1.6 Research Questions ... 32
1.7 Basic Hypotheses ... 34
1.8 Design of the Study ... 35
1.9 Outline of the thesis ... 36
Chapter 2. Review of literature... 39
2.1 Introduction ... 41
2.2 Computer Mediated Communication ... 43
2.2.1 Electronic discourse ... 46
2.2.2 Web genres ... 48
2.2.3. State of the art in Electronic Responses in Linguistics ... 51
2.3 Genre Analysis ... 56
2.3.1 Traditions ... 57
2.3.2 Definitions/Concepts ... 62
2.3.3 Moves, steps & strategies ... 66
2.3.4 Discourse communities ... 68
2.3.7 Genre Analysis in Medicine ... 76
2.3.7.1 Letters to the editor in Medicine ... 82
2.3.7.2 English as a lingua franca on the Internet and in medicine ... 85
2.3.8 Corpus Linguistics ... 86
2.4 Chapter summary ... 89
Chapter 3. Methodology ... 91
3.1 Introduction ... 93
3.2 Criteria for the Selection of the Corpus ... 94
3.2.1 Journal relevance ... 94
3.2.2 Representativity ... 94
3.2.3 Accessibility ... 96
3.3 The corpus ... 97
3.3.1 Data collection ... 99
3.3.2 Corpus Size ... 100
3.3.3 Corpus Storage and Handling ... 101
3.3.4 List of Electronic Rapid Response Texts ... 102
3.4 The Operational Research Framework ... 103
3.4.1 Quantitative Applied Linguistics ... 103
3.4.2 Qualitative Applied Linguistics ... 104
3.5 Chapter Summary ... 106
Chapter 4. Quantitative results ... 108
4.1 Introduction ... 110
4.2 A Cross Subgenre Study of Basic Language statistics on thebmj.com ... 110
4.2.1 Electronic rapid responses elicited by thebmj.com genres ... 110
4.2.2 Number of Words Per Electronic Rapid Response Type... 113
4.2.3 Sentence Number and Sentence Length in e-Rapid Response types. .. 114
4.3 Most frequent words in subcorpora on e-Rapid responses on thebmj.com 115 4.3.1 Most frequent words in e-Rapid Responses to e-Editorials ... 115
4.3.2 Most frequent words in e-Rapid Responses to e-Research Articles .... 117
4.4 Chapter Summary ... 120
Chapter 5. The rhetorical structure of electronic rapid responses to online
BMJ editorials ... 122
5.1 Introduction ... 124
5.2 The Rhetorical Structure of Electronic Rapid responses to online BMJ editorials ... 130
5.2.1 Title ... 133
5.2.2 Opening ... 134
5.2.3 Body ... 137
5.2.3.1 Social Acknowledgment/Focus ... 139
5.2.3.2 Showing agreement or disagreement ... 149
5.2.3.3 Reference to medical background knowledge ... 151
5.2.3.4 Indication of editorial content effects ... 153
5.2.3.5 Question raising ... 154
5.2.3.6 Indication of a gap ... 156
5.2.3.7 Indication of problems ... 157
5.2.3.8 Indication of solutions ... 159
5.2.3.9 Criticism ... 159
5.2.3.10 Counterclaiming ... 161
5.2.3.11 Reference to or description of medical case ... 162
5.2.3.12 Reference to experience ... 163
5.2.3.13 Call for change ... 164
5.2.3.14 Words of warning ... 166
5.2.3.15 Clinical practice ... 167
5.2.3.16 Situation ... 168
5.2.3.17 Clarification ... 169
5.2.3.18 Own research ... 169
5.2.3.19 Interpretation ... 171
5.2.3.20 Implications ... 172
5.2.3.21 Conclusion ... 172
5.2.4 Closure ... 173
5.3 Chapter Summary ... 174
Chapter 6. The rhetorical structure of electronic rapid responses to online BMJ research articles ... 176
6.1 Introduction ... 178
6.2.1 Title... 186
6.2.2 Opening ... 187
6.2.3 Body ... 190
6.2.3.1 Social Acknowledgement ... 192
6.2.3.2 Criticism ... 197
6.2.3.3 Indication of Effects ... 199
6.2.3.4 Indication of a problem ... 200
6.2.3.5 Indication of a solution ... 202
6.2.3.6 Background Knowledge ... 202
6.2.3.7 Showing agreement or disagreement ... 203
6.2.3.8 Consideration of evidence ... 205
6.2.3.9 Reference to personal experience ... 207
6.2.3.10 Own Related Research ... 208
6.2.3.11 Signalling Gap ... 210
6.2.3.12 Situation ... 211
6.2.3.13 Question Raising ... 212
6.2.3.14 Question Answering ... 213
6.2.3.15 Clarification ... 213
6.2.3.16 Counterclaiming ... 215
6.2.3.17 Words of warning ... 216
6.2.3.18 Acknowledging limitations ... 217
6.2.3.19 Call for change ... 218
6.2.3.20 Interpretation ... 219
6.2.3.21 Implications ... 220
6.2.3.22 Conclusion ... 220
6.2.4 Closure ... 221
6.3 Chapter Summary ... 222
Chapter 7. The structures of electronic rapid responses on thebmj.com ... 224
7.1 Introduction ... 226
7.2 E-RR purpose in the BMJ PPORD ... 226
7.3 Moves in e-RR type structure ... 228
7.4 Strategies in e-RR type structure ... 229
Chapter 8 Conclusions ... 238
Thesis summary in Spanish (Resumen de la tesis en español) ... 258
BIBLIOGRAPHY ... 270
Appendix 3.1 List of e-RRRA Texts for Qualitative Analysis ... 304
Appendix 3.2 List of e-RRE Texts for Qualitative Analysis ... 322
Appendix 5.1 Rhetorical structure of electronic rapid responses to editorials .... 336
Appendix 6.1 Rhetorical structure of electronic rapid responses to research articles ... 356
Table 3.2. Corpus for qualitative analysis ... 100
Table 4.3. Length of e-RR types ... 113
Table 4.4. Sentence number and sentence length per e-RR type ... 114
Table 4.5. Most Frequent words in e-RREs (1-50) ... 115
Table 4.6. Most Frequent words in e-RREs (51-100) ... 116
Table 4.7. Most frequent words in e-RRRAs (1-50) ... 118
Table 4.8. Most frequent words in e-RRRAs (51-100) ... 119
Table 5.1. e-RRE purpose in the PPORD ... 125
Table 5.2. Strategies in e-RREs ... 133
Table 6.1. e-RRRA purpose in the PPORD ... 179
Table 6.2. Strategies in e-RRRAs ... 185
Table 7.1. Purposes per e-RR type ... 227
Table 7.2. Moves and e-RR type... 228
Index of Figures
Figure 1.1. Framework for the research ... 4
Figure 1.2. Traditions framing thebmj.com e-Rapid Responses ... 4
Figure 1.3. The development of open access publishing 1993-2009 (from Laakso, M et al; 2011: pp 1) ... 6
Figure 1.4. Springer and Björk Open Access rates ... 8
Figure 1.5. A sample BMJ webpage ... 12
Figure 1.6. The thebmj.com Review Process ... 16
Figure 1.7. Sample rapid response debate elicited by editorial... 20
Figure 1.8. Sample rapid response debate elicited by research article... 22
Figure 1.9. Sample article cover page ... 26
Figure 1.10. A sample e-Rapid Response to an online Editorial ... 28
Figure 1.11. A sample e-Rapid Response to an online Research Article ... 29
Figure 2.1. The framework for electronic English for medicine... 41
Figure 2.2. Electronic rapid responses in CMC (EMC) (Adapted from Baron: 2008:14) ... 45
Figure 2.3. Purpose of research-related genres ... 72
Figure 2.4. CARS model for Article Introductions (Swales, 1990: 141) ... 73
Figure 2.5. CARS revised by Swales and Feak (1994) ... 75
Figure 2.6. Swales’ revised model for research article introductions (2004: 230- 232) ... 76
Figure 2.7. Skelton’s Medical research Paper structure (1994; cited in Helán 2012: 48) ... 80
Figure 2.8. Medical research paper (Nwogu, 1997)... 80
Figure 2.9. Hoey’s (2001: 130) problem-solution pattern in the organization of texts ... 81
Figure 2.10. Rhetorical Structure of Letters to the Editor (Vázquez, 2005:156) .. 84
Figure 4.1. Responses elicited by thebmj.com editorials and research articles ... 110
Figure 4.2. Average number of responses per contested editorial and research article ... 112
Figure 5.1. Framework for e-RREs ... 129
Figure 5.2. Generic structure and rhetorical structure of a sample e-RRE. ... 131
Figure 7.1. Strategies in e-RRs (I) ... 231
Figure 7.2. Strategies in e-RRs (II) ... 233
Figure 7.3. Strategies in e-RRs (III) ... 234
Figure 7.4. Strategies in e-RRs (IV) ... 235
Figure 7.5. Strategies in e-RRs (V) ... 236
Figure 7.6. Strategies in e-RRs (VI) ... 237
Index of Acronyms
▪ Acronyms in Dissertation
BMA British Medical Association
BMJ British Medical Journal
CARS Create a Research Space
CDA Critical Discourse Analysis
CMC Computer Mediated Communication
DOAJ Directory of Open Access Journals
e-Article Electronic Article e-Cluster Electronic Cluster
e-E Electronic Editorial
e-Editorial Electronic Editorial
e-Genre Electronic Genre
e-Health Electronic Health
e-Innovation Electronic Innovation e-Journal Electronic Journal
EMC Electronically Mediated Communication
e-RR Electronic Rapid Response
e-Rapid Response Electronic Rapid Response*
e-RA Electronic Research Article
e-Research Article Electronic Research Article*
e-Responder Electronic Responder
e-RRRA Electronic Rapid Response to Research Article
e-RRE Electronic Rapid Response to Editorial
EAP English for Academic Purposes
ESP English for Specific Purposes
HINARI Health InterNetwork Access to Research
Initiative
ICT Information & Communication Technology
IRC Internet Relay Chat
ISI Institute for Scientific Information
NS Native Speaker
NNS Non- native Speaker
OA Open Access
PIRA Printed Introduction of ResearchArticle
PLoS Public Library of Science
PhDTI PhD Thesis Introduction
PPORD Post-publication Online Review Debate
RA Research Article
RECON Relationships and Confidence
SA Social Acknowledgement
* A two-fold acronym system has been used in this dissertation to be employed discretionally in both the text and in Figures and Graphs to avoid difficulties –caused by the presence of a high number of acronym occurrences in text segments.
Thesis Summary
A GENRE APPROACH TO ELECTRONIC RAPID RESPONSES FROM THE ONLINE BRITISH MEDICAL JOURNAL
This study is undertaken as a practical instance of Comparative Discourse Analysis. Within Genre-Analysis, a field within the tradition of Discourse Analysis, this thesis first quantitatively characterizes word frequency in a corpus of Electronic Rapid Responses (e-RRs) in the British Medical Journal (BMJ). It then examines differences in the organization of discourse in two of the medical subgenres in the journal, Electronic Rapid Responses to Editorials (e-RREs) and Electronic Rapid Responses to Research Articles (e-RRRAs).
The corpus for the quantitative study is comprised of 1,750 e-RRs retrieved in 2006; word frequency, text-type length, sentence number & sentence length are estimated. The corpus for the qualitative study comprises 200 texts, examples of expert-to-expert communication, 100 e-RREs and 100 e-RRRAs.
The cross-genre study yields subtle differences in terms of sentence length & text type length and qualitative differences in the most frequent words in the subcorpora. The analysis in the qualitative study shows a common generic structure for e-RREs and e-RRRAs, stemming from epistolary genres with similar range of strategies, but significantly different at a strategy level.
This thesis provides evidence to support the view that major contextual factors influence online medical subgenres such as e-RRs. Along with subject matter, purpose, an allegedly worldwide audience and medium of discourse, the content
of e-RRs as review subgenres seems to be influenced by major social factors such as scientific norms, conversational maxims and an online context. In this sense, this thesis is a contribution to research in the field of social factors in genre analysis and in that of review genres in medicine.
Key words:
Genre Analysis, Medical Discourse, Electronic response, Social factors, Computer Mediated Communication
CHAPTER 1.
INTRODUCTION
1.1 General aim of the thesis
The main aim of this dissertation is to offer a corpus-based linguistic description of electronic Rapid Responses (e-RRs) in the British Medical Journal, more specifically, it aims at providing a synchronic picture of e-Rapid Responses to online editorials and research articles. Computer Mediated Communication (CMC) in the field of medicine yields an array of hybrid online genres among which BMJ electronic rapid responses as an epistolary subgenre should be included. The rhetorical organization of these newly emerged subgenres in the field of medicine has not been extensively researched and, to the best of our knowledge, no study has attempted a quantitative & qualitative approach to e-RRs on thebmj.com. The research referred to in this thesis is an attempt to fill this gap.
Hence, in broader terms, I would like to contribute to the study of electronic English for medicine, specifically the purely online medical subgenre of e-RRs.
This study focuses on e-RRs to online Editorials & Research articles on thebmj.com as emerging online subgenres in the field of medicine due to the fact that they are key constituents of the BMJ post publication review process in the digital era.
In the following paragraphs a broad framework of e-Rapid Responses, the object of study of this thesis, is offered. As they pertain to Electronic English for Medicine, e-Rapid Responses can be assumed to lie somewhere within the space where three fields overlap; namely, English, Medicine and the Internet.
▪
Figure 1.1. Framework for the research
E-RRs are a recently emerged and understudied e-subgenre in the medical field, as such they may share some characteristics –and be similar to or different from- those existing in printed Academic English traditions. They seem to be related to, and/or stem from, the following academic literature traditions, English for Medicine, English for Academic Purposes, peer publication reviews, electronic debates on health topics and Internet English. These will be looked at in the next chapter, a review of the related literature.
Figure 1.2. Traditions framing thebmj.com e-Rapid Responses
The analysis aims to contribute to ascertaining whether these emerging electronic genres, Electronic Rapid Responses to Editorials (e-RREs) and Electronic Rapid Responses to Research Articles (e-RRRAs) stem from those that characterize the printed medical tradition; with reference to the communicative situations in which they take place.
This study aims to supply quantitative data on thebmj.com e-RRs and reveal their rhetorical structure; as constituents of the online post publication review process of editorials and research articles. Thus, emphasis has been placed on the rhetoric of e-RRRAs and e-RREs, as an analysis of their rhetorical structure –in the framework provided by genre analisis– may eventually contribute to medical scientists’ awareness of the existing academic conventions and rhetorical strategies, and hence, contribute to medical scientists’ eventual participation in open post-publication review of e-articles and in e-health debates in electronic journals.
To summarize, the general aim of this thesis is to explore a recently emerged e- subgenre in the field of electronic English discourse, that of BMJ electronic rapid responses as part of the BMJ open initiative. In other words, it aims to contribute to the study of new e-subgenres in the field of medicine, particularly of those which, among others, embody the recently emerged open review movement in electronic journals such as thebmj.com.
This study may be relevant to experts in medicine, lay medical professionals, BMJ readers, and ESP linguists interested in the analysis of online genres, English for Academic Purposes and Internet English. Research, which may help raise awareness
of these features among scholars, experts in medicine and the broader BMJ readership and eventually contribute to a fuller and better online post-publication review process in the fields of research in medicine, and to a fuller and better accommodation of new knowledge in the medical field.
1.2 Rationale for the research
The dramatic growth of Open Access (OA) has meant that over 9,171 peer-review open access journals, from 134 countries, covering all areas of science, technology, medicine, social science and humanities are listed in the DOAJ (Directory of Open Access Journals). Open Access (OA), in the context of scholarly publishing, has been defined as “unrestricted online access to articles published in scholarly journals”. Here it is used to refer to scholarly, peer-reviewed journals in which all content is made available on the web, either exclusively online or together with a subscription print version.
Figure 1.3. The development of open access publishing 1993-2009 (from Laakso, M et al; 2011: pp 1)
Previous research has distinguished between Gold Open Access and Green Open Access. Green Open Access entails self-archiving of the author’s work –by, for example uploading a version of an article to the author’s personal homepage or to an institutional repository. In Gold Open Access the document is made available by the Publisher, which means that the content of the actual journal publishing the article is either totally or to some extent freely accessible to the public. Direct Open Access – which is estimated to account for 62% of all Gold Open Access–entails that the whole journal is Open Access without any limitation. Delayed Open Access, which is estimated to account for 14% of all Gold Open Access, exists when the most recent content is made accessible only to paying subscribers, but over the passage of time, the restriction or embargo is lifted and the content is made available to all.
Hybrid Open Access entails that an author or the author’s institution pays for an article to be made freely available in an otherwise subscription-based journal.
Hybrid OA is estimated to make up 24% of all Gold OA within digital communication.
Although, in medicine, 2010 estimations of Gold OA articles have reached 13.9%
and of Green Open Access 7.8% (Björk B-C et al, 2010), extrapolation of OA curves for the next two decades estimate yearly increases of 20-30% and indicate that the different types of OA would reach 100% in 2022 and 2029 respectively. In addition, there are also substantial increases in Green OA self-archiving (Poynder, 2011).Estimates2 are displayed in Figure 1.4. below:
2 From http://www.richardpoynder.co.uk/Open_Access_By_Numbers.pdf (last accessed January 8, 2014)
Figure 1.4. Springer and Björk Open Access rates
The long-standing academic standard of double-blind peer review has shaped the process of accepting new knowledge within scientific fields. Great efforts are being made to transform this process and open it up. In this sense scholars and academics have been calling for “open access” as a means to overcome the divide between rich and poor researchers, institutions and countries. Some have also called for “open review” as a way to break down some of the access barriers that conform knowledge production, its judgment and its availability to readers.
Online peer review is a long way from being totally implemented as an alternative to traditional peer review. Journal initiatives that experiment with it favour hybrid solutions, considering it a helpful, parallel process which provides input from a wider audience and focuses on details that most reviewers may have overlooked before submitting a paper for review and publication (Timmer, 2006) or parallel in time to the review process (Nature 2006 Open trial). Its full implementation faces problems among which we can include low levels of authors’ willingness to go public for online comment. BMJ e-RRs constitute one of the existing options of realization of this online post-publication review process.
E-RRs have been chosen for the present research because of their importance in the online BMJ post publication review process and for their relevance in the accommodation of new knowledge within the BMJ community, medical research and medicine in general. In the future, they are likely to constitute a complementary key medium for the legitimation of claims and new knowledge in the medical sciences.
1.3 Background to the thesis
1.3.1 The e-Health Revolution
The past 50 years have witnessed significant gains in health all around the world, due to advances in science, technology, medicine, expanded infrastructures, rising incomes and better nutrition, sanitation and literacy. But in many countries fundamental conditions for health have not been achieved –peace, shelter, education, food, income. The global health picture today is one of extreme
diversity and inequity, with increasing long-standing gaps between the health status of the wealthy and that of the poorest sectors of the population.
E-health has been defined as the use of emerging ICTs, noticeably the Internet, to improve or enable health and health care (Eng, 2000). In medicine, commercial, industrial, and scientific spheres of activity increasingly high levels of computer presence have been revealed; indeed computers and information technologies are becoming omnipresent in medicine and research in this digital world. Hence, ICT is essential for health systems to meet their obligation to deliver care, and monitor public health; it helps the coordination of complex activities, ensures quality, fosters collaboration and knowledge sharing. Its value lies in the information exchange it can provide and its capacity to bring people together, building partnerships and joint programmes of action. Health care, therefore, has a potential for improvement through e-innovation; e.g: electronic medical records, electronic databases or computerized clinical decision-support systems have been developed for a myriad of clinical issues. The emergence and widespread use of medical e-journals is one of the developments that originated in the e-health revolution. This journal, thebmj.com, will be referred to in the next section.
1.3.2 The British Medical Journal
The BMJ (British Medical Journal) is an international peer reviewed medical journal. It is published weekly by the British Medical Association (BMA)3, has
3 BMJ is considered to be one of the 'core' general medical journals; other journals in this group are the New England Journal of Medicine (N Engl J Med), the Journal of the American Medical Association (JAMA) and The Lancet. The Canadian Medical Association Journal (CMAJ) and Annals of Internal Medicine have also been included in this category by some authorities.
broad worldwide readership4, and it is indexed by all the major services (e.g:
PubMed, MEDLINE, EBSCO, ISI).
The BMJ’s Impact Factor is 17.445 (ISI Web of science 2015); it was 9.245 in 2006. The BMJ publishes articles from doctors and others from anywhere in the world. Only about 7% of the 7000-8000 articles submitted are published each year.
The BMJ is characterized by a continuous “online first” publication model, which means that all articles appear on thebmj.com before being included in an issue of the print journal. All the BMJ’s original research is published in full on thebmj.com, with open access and no limits on word counts. The full text of every research article published in the BMJ is immediately accessible on thebmj.com through open access, for everyone. Moreover, the journal is committed to keeping research articles openly accessible.
The BMJ’s mission is to lead the debate on health and to engage, inform, and stimulate doctors, researchers, and other health professionals in ways that will improve outcomes for patients. It aims to help doctors in decision-making. And its vision is to be the world’s most influential and widely read medical journal.
The highlights of the BMJ are the print content, supporting material for original research articles, additional news stories, and electronic letters to the editor. Its website is updated daily with a range of articles which includes original research articles, education articles, news, letters, review articles and comment articles on
4 The BMJ visitor statistics were 656,118 in 2006
the clinical, scientific, social, political, and economic factors affecting health. It also publishes podcasts, videos, blogs and electronic rapid responses. Its website underwent some design changes in November 2011; there were also some changes to access controls in January 2012. A BMJ sample webpage is illustrated in Figure 1.5. below5.
Figure 1.5. A sample BMJ webpage
The BMJ has a long history6, which is outlined below:
1840 The BMJ began as the Provincial Medical and Surgical Journal -printed BMJ- and has been published without interruption since then.
1995 The BMJ became the first general medical journal to launch itself into cyberspace as BMJ.com. All its issues have been archived on the web since then.
5 BMJ webpages include interactive facilities like links to e-rapid responses, citations and services.
6 From bmj.com (last accessed 07/29/2015)
1999 All content of BMJ was made freely available online in 1999.
2005 BMJ keeps research open access but starts to charge for non-research content.
2006 The BMJ changed to a subscription model. Original research articles continue to be available freely, but from that date onwards, all other 'added value' contents, including clinical reviews and editorials, required a subscription7. Access restrictions were lifted a year after publication. E-RRsremain open accessible.
2008 The BMJ announced it would become an open access journal –this only referred to research articles. It allowed complete free access for visitors from economically disadvantaged countries as part of the HINARI initiative.
2009 Since this date every BMJ article published has been available online from BMJ.com in the BMJ archive and PubMed Central. Non-research articles in the archive have required a subscription. Subscribers and BMA members have access to all archive content from the current issue back to 1840.
2011 BMJ launched as an online, author-pays, open access journal.
2012 Most BMJ revenues originate from outside the UK. The group now has editorial, sales and support staff in a dozen countries, with major business and editorial centres in the US and India.
2013 The BMJ launches an initiative to champion partnership between doctors and patients in healthcare and research.
2014 Interactive graphics launched on thebmj.com
2015 The BMJ website celebrates its 20th Birthday with an anniversary editorial, accompanying feature and podcast, and an infographic charting its online history.
The BMJ website policy nowadays is that of publishing most e-letters (e-RRs) to the journal.The interface of thebmj.com is formatted like a fully moderated Internet forum.
7 The BMJ's sources of revenue include subscriptions from institutions and individuals, advertising for jobs, courses, pharmaceutical and non-pharmaceutical products, events (exhibitions, sponsorship, and visitor fees), sale of reprints, rights, royalties and sponsorship. All authors are asked to pay an Open Access fee of £2500 on acceptance of their paper. BMJ has a waiver policy for authors who cannot pay, the consideration of their research articles is not related to ability to pay the fee.
1.3.3 The British Medical Journal review policy
Peer reviews have existed since the 17th century. They have remained anonymous for centuries and accessible only to a selected group of members in the scientific community (Posteguillo, Piqué-Angordans & Edo, 2008). Peer review is present in most professional journals; however, it did not evolve into an institutionalized process until 1940s. Through peer review the editorial board and referees try to guarantee that research reports and different types of articles are worth publication, assuring a quality product. Swales (1996) considered it as an “occluded genre”. In this peer review system “expert knowledge-holders, knowledge-builders and factual reporters” (Salager-Meyer & Alcaraz Ariza, 2011) have played a major role as referees and gate keepers. These authors have addressed the wide context of the rhetoric of science. According to these authors (ibid 2011:1)
The study of the rhetoric of science is thus concerned with persuasive communication and the relation between text and power. To have power in the scientific community is not only to be able to persuade the community of the correctness or probability of one’s own truth claims, but also to be able to refute peers’ claim with robust, well-founded arguments. Indeed, the rhetoric of science is essentially discussion-oriented, i.e., dialogical, in the sense that the quest for the unbiased “truth” …demands a consequent skepticism towards established truths.
The peer review system has been questioned in the last few decades, claiming the need to make it more democratic and less biased towards private interests (Godlee &
Jefferson, 1999; in Piqué-Angordans & Camaño-Puig, 2008).
The BMJ has an open peer review policy, which is a very important quality factor for journals and authors. First, this means that reviewers are asked to sign their reports and declare any competing interests on any manuscripts they send.
Second, reviewers advise the editors, who make the final decision. BMJ articles
can eventually be externally peer reviewed. Peer review by editors and external reviewers on research and other scholarly articles can be appealed and many appeals succeed. For opinion articles, where editorial judgement about readability and engagement weighs most heavily, an appeal is less likely to overturn the editorial decision. The BMJ peer review process is illustrated in the report excerpt below:
The paper went through detailed peer review and was seen by expert reviewers active in this field. It was also seen by a statistics editor with specific expertise in this type of research methodology, and was accepted at the BMJ's research manuscript committee meeting (subject to revisions, which the authors then made).
At the revision stage the authors responded thoroughly to all comments made by peer reviewers and the BMJ's research editors and statistics editor. One request was for the authors to conduct a standard meta-analysis in addition to their network meta-analysis. This additional analysis was published as web extra 2 alongside the article on BMJ.com […] The criticisms raised in the rapid responses mainly address possible unmeasured confounding factors, and hence continue the debate but do not negate the findings of the study.
[BMJ 2010; 341: c4675]
The open Peer Review process constitutes a new era of implementation.
Experimentation in Pre and Post Publication review of scientific publications is
taking place8, and many new innovations in scholarly publication are being tried throughout the world.9
Figure 1.6. The thebmj.com Review Process
Third, as far as post publication review is concerned, very few journals have a system like the BMJ or Annals of Internal Medicine Rapid response system. At the BMJ, elctronic Rapid Responses are a way of carrying out the continuing appraisal of published articles. Perfect peer reviews are rare because reviewers are not likely to be experts in all aspects of the studies reviewed. They may fail to discover some flaws, and flawed papers can be cited uncritically. That is the reason why rapid responses have a complementary purpose. Post-publication review remains important in the identification of statistical errors (Delamothe T, Smith R; 2002) and unconsidered possible biases (Bydder S et al; 2000).
8http://www.bmj.com/rapid-response/2011/11/02/open-peer-review-process-new-era- experimentation-pre-and-post-publication-last accessed April 4th 2012
9 Nature (Schriger, D et al, 2010) tried an open review experiment in 2006 –with an acceptance rate of 74% among authors, who recognized that their paper had improved-, then Lancet (2005) and now Shakespeare Quarterly has tried an open review method of peer review by MediaCommons Press.
1 Paper submission
to BMJ
3 Paper online
publication
4 Open review by BMJ readership 2
Review by BMJ editorial board or reviewers
1.3.4 Open Post Publication Review Debates
On their launch, electronic rapid responses (e-letters to the editor nowadays) were seen as the solution of BMJ's need to provide opportunities for timely debate after the online publication of a paper. Previously, only about one third of the letters to the editor received had been published, and those about six months late.
The BMJ welcomes different types of responders: doctors, patients, health professionals, non-doctors, people from the UK, people from other countries, members and non-members among others. The e-rapid response was, and still is, an arena where the interplay of the e-responder agency in the review provided and the role of previous academic production is revealed.
At thebmj.com e-Responses can be edited before and after publication, although minimal editing is done. In this way, the onus for correct spelling and punctuation is placed on the authors, and the author’s name is published with each e-response.
Marking the publication of the 20,000th response in 2002, the BMJ judged the experiment a success, even suggesting that rapid responses might point towards new models of knowledge creation, although the standard was not uniformly high and a few individuals seemed to be commenting on almost everything, but in 2005 the editorial policy suffered a major change:
Having now posted our 50000th rapid response, both the upsides and the downsides have become more obvious. The upsides are that rapid responses allow important criticisms to be made immediately after publication and that this form of peer review can continue indefinitely. Groups beyond the print journal's usual readership (such as patients and readers outside the United Kingdom) can contribute, and discussions can range beyond the original findings to suggest new avenues of research. […] The main downside of rapid responses is that the bores are threatening to take over. Some responders feel the urge to opine on any given topic, and pile in early and often, despite having little of interest to say. Others have pet topics, which they return to obsessively, finding almost any peg to hang their views on. Some responders don't seem to feel they're really alive until they've sparked off an angry response from someone else. Rows then continue for longer than interests anyone other than the combatants. Attacks on views can move swiftly to attacks on the holder of those views; these were often continued via abusive emails until we stopped posting email addresses with responses. Our impression was that the overall quality of responses was falling. Responders whose views may have been worth reading told us they weren't contributing because of the conditions of engagement
(Davies, Sharon; Delamothe, Tony, 2005).
Their solution was to enforce more rigorously their original criterion for publication, namely that a response contributes substantially to the topic under discussion, which meant raising the threshold for acceptance, and merely reaffirming their editorial responsibility to readers; i.e., by filtering out some of them to encourage more thoughtful and reasoned postings. They recommended that responses be no more than 500 words in length and never longer than 1000 words as these would not be published, and their preferred limit for letters in the paper journal, which were at the time all selected from the rapid responses, was 250-300 words.
Nowadays, to respond to articles, thebmj.com readers are required to submit
letters to the editor as rapid responses. They can use search on thebmj.com to find a particular article and then click on the link at the top of the page marked
"Respond to this article" (see Figure 1.6.). There is no other way to submit a letter to thebmj.com. All letters that appear in the print BMJ and on thebmj.com arrive initially as rapid responses. Rapid Responses are electronic letters to the editor. E- rapid responses, then, enable thebmj.com users to debate issues raised in articles published on the journal webpage.
All responses are eligible for publication. A selection of rapid responses is eventually included as edited readers' letters in the weekly print issue of the BMJ, although editing proofs of e-rapid responses are not sent to their author. Their first appearance online means that they are published articles. Any competing interests
must be declared and they are posted daily. It is at the editors’ discretion whether they publish any particular response 10.
The following figures illustrate the selection of thebmj.com open debates that this thesis has focused on; i.e. the clusters of e-genres which instantiate the e-debates on online editorials and research articles.
The online publication of these online genres is likely to be followed by electronic activity in the form of e-rapid responses: E-Rapid Responses to Editorials, e- Rapid Responses to Research Articles. The result is a cluster of e-genres in which the original online editorial or research article is the nucleus. And review is provided in the form of e-RRs.
The figure below is the product of a sample analysis of the e-debate elicited by, and after, the online publication of an editorialon thebmj.com. This figure offers the map of a cluster of e-genres in a broad time framework.
10 i.e. They do not publish responses, that they think are not appropriate, are likely to end up in litigation and/or appear to be, obscene, libelous in some other way illegal -for example, inciting racial hatred, contempt of court, breach of intellectual property rights-, incomprehensible, insubstantial, written in capital letters, not written in English, almost entirely a quote from somewhere else, gratuitously rude, blatant advertising, or that give information on patients without their written consent, or are sent by someone who does not provide adequate and accurate personal details including a functioning email address, or from people they suspect have used an alias, or who does not respond to email.
Figure 1.7. Sample rapid response debate elicited by editorial
As we can see from the chart, after the online publication of an editorial on thebmj.com, time was given for e-debate, and electronic facilities were provided by the e-journal. This meant time for worldwide thebmj.com readers to read the editorial, process it cognitively and emotionally and write a response, to, once posted, be read potentially by a worldwide international readership. This produced a cluster11 of e-genres with a centre in the editorial published.
The first e-rapid response to the editorial appeared four days later and the second was published four days later as well and seven days after that two other e-rapid responses were posted. After some time, a fifth response appeared online at the end of the following month. That constituted a void period for electronic activity in this e-health debate. And, eventually, a sixth rapid response was published several weeks later; a relapse period can sometimes be considered as a hint that the e-health debate is over. Very rarely is a last rapid response written in reply by
11 The term ‘cluster’ of e-genres is introduced here to refer to the e-genres throughout which a topic debated online develops, extends. It may include, for example, an editorial about the topic researched in an article in the same issue of a journal, the article itself, and the e-RRs to both.
the author/s of the original editorial as a response to observations made in e-RRs during the e-health debate and/or as a way to close the whole process.
E-debates elicited by the publication of online editorials seem to vary in terms of the number of e-rapid responses received; some seemed to have elicited one or no responses at all, whereas some others may have elicited higher figures. In the corpus for this thesis the average number of e-rapid responses per text-type and e- health debate has been estimated for the time-span selected (see section 4.2.1).
Several reasons might account for a particular number of responses elicited by a research paper or editorial. Among these we could mention the degree of interest raised by the editorial on thebmj.com readership, and the creation of academic conflict created by the editorial, dilemmas that arise and/or the width of the scope of the editorial at an international level, and the quality of the editorial.
E-rapid responses seemed to distribute online publication unevenly throughout the open review period. In this case, a clustering of e-rapid responses during the first months can be observed. A possible interpretation can be that authors were probably contesting the hotter or more evident editorial topics causing dilemma;
later, e-rapid responses seemed to tail off and in this case, a possible interpretation could be that adding something new to the debate might be difficult or also that the topic does not raise further interest in a challenging context of new articles coming up online on a weekly basis.
But it is not until after we have looked into the e-health debate that we can truly register the e-rapid response review content, which complements the pre- publication review in the hands of BMJ reviewers, nor the purpose of each e-rapid
response in the context of the e-health debate or the particular editorial items considered and/or rhetorical devices employed. This thesis is an attempt to do so.
Figure 1.8. depicts the sample analysis of the e-debate elicited by, and after, the online publication of a research article. This figure offers the map of a cluster of emerging e-genres in a broader time framework on thebmj.com in the digital communication process.
Figure 1.8. Sample rapid response debate elicited by research article
After the online publication of the research article on thebmj.com, about acceptability of low molecular weight heparin thromboprophylaxis for inpatients receiving palliative care: qualitative study12- time was given for e-debate - and electronic facilities were provided by the e-journal. This meant time for thebmj.com worldwide readers to assess the RA, process it cognitively and emotionally and write a response–to be read potentially by a worldwide international readership.
12 S I R Noble, A Nelson, C Turner & IG Finlay.BMJ2006;332: doi:10.1136/BMJ.38733.616065.802
The first e-rapid response appeared in the following week and the second was published on the following day; two other e-rapid responses were published ten days later, and these were followed by the scattered online publication of a series of e-RRs in October. A last, e-rapid response was published in November, perhaps after a relapse period indicating that the e-health debate was over, and, maybe again, as a response written by the author/s of the original research article in reply to observations made in e-RRs during the e-health debate and as a way to close the debate.
On the other hand, E-debates elicited by the publication of online research articles seemed to vary in terms of the number of e-rapid responses received. Some of these articles seemed to have elicited one or no responses at all, whereas some others may have elicited higher figures. In this thesis the average number of e- rapid responses per research article and e-health debate will be estimated for the time-span selected (see section 4.2.1). Several reasons might account for a particular number of responses elicited by a research paper or editorial. Among these one could mention the degree of interest raised by the e-research article in the BMJ readership, or the research article (assertions or claims) capacity of creation of academic conflict and/or dilemmas, the contribution to the field made by the research at an international level or the quality of the research.
The e-RRRAs also seemed to distribute their online publication unevenly through the open review period. In this case, the clustering of e-rapid responses observed was distributed more evenly. Again, a possible interpretation could be that they were probably contesting the hotter or more evident editorial topics that were
causing discussions or controversy, probably complementing the observations made by other e-rapid responses –as an effect of the BMJ editorial policy, which probably made the task of finding something new to add to the debate more complicated for later e-responders. Thus, it is not until after we have explored the e-health debate that we can truly register the e-rapid response medical review content, which complements the pre-publication review in the hands of BMJ reviewers, nor the purpose of each e-rapid response in the context of the e-health debate, the particular research article aspects considered by the e-RRs and/or the rhetorical devices employed to argue their viewpoints.
1.4 Electronic Rapid Responses to online genres
Being a medical scientist involves doing myriad tasks; among these the provision of comment and feedback has been well documented. The review of scientific papers clearly entails an assessment task essentially based on a subjective opinion of a reviewer, who may refer to the contents of a particular paper, RA or editorial, and, most importantly, evaluate it according to his/her expertise and knowledge of the topic, field, medical practice and clinical experience. Hence a review can be seen as a personal interpretation based on the reviewer’s knowledge of the discipline and influenced by his/her particular view of the topic under discussion.
The rise of the Internet and the growth of digital communication have provided new spheres and possibilities for interaction with initiatives such as thebmj.com e- rapid responses fora. The BMJ webpage offered the possibility of posting an e-RR to most of its published documents and it was observed that these seemed to serve a wide range of purposes. In this thesis these purposes have been identified and
selected for study. The categories selected were e-RREs and e-RRRAs.
Particularly, e-RRRAs were selected because the post-publication review of RAs has strategic importance as it helps the accommodation of new knowledge into the medical field. E-RREs were selected because editorials offer a state-of-the art picture of a particular area, usually from an expert’s point of view, and e-RREs help validate the cutting-edge knowledge they provide.
E-RRs are crucial and essentially related stages of the post-publication review process of editorials and research articles in the BMJ medical community. They seem to be the expression of the readers’ cognitive processing of the particular e- genre information.
The navigation through the online BMJ provides an insight into a particular network of topic-based e-genres. The following article cover page (Fig. 1.9.), for instance, informs the reader on the electronic network of genres related to an online editorial, the rapid responses posted to the online editorial, the facility to post a rapid response, related articles expression of the extension of the thematic subject area through the e-network, as well as, an email alerting service, which allows the researcher to receive incoming news, recently published papers, on the subject area and to be updated.
Figure 1.9. Sample article cover page
In other words, this sample cover page informs the BMJ reader on the e-debate on this e-Editorial, on further citations, on the opportunity to continue the e-debate and on related articles; that is, how the e-debate stretches outwards through the network. On the other hand, it provides a link for the reader to double-click on and dive into the e-debate through thebmj.com (inwards), thus accessing another new knowledge microcosmos.
On thebmj.com the Rapid response interface has been upgraded; there is now a separate tab at the top of each article and a click on this shows you the latest responses. E-Rapid Responses can also be ranked by popularity and by date. And original authors of BMJ articles can respond to a particular e-rapid response using this standard rapid response interface that also facilitates navigation.
The term rapid response could lead the reader to an initial conceptualization of an e-Rapid Response to an online paper as an immediate, spontaneous, maybe brief, written expression of a reader’s initial cognitive and emotional response elicited by the online publication of a paper. I would like to hypothesize that BMJ readers are likely to have gathered a similar idea, as the term was also new for them at the time. In fact, this term, rapid response, seems to have acted as a call for the BMJ readers’ initial response to the reading of a particular online article, with a wide range of realizations. The following figure illustrates a sample e-Rapid Response to an online editorial.
The real reason for not dilating?
The editorial by Liew, Mitchell and Wong [1] discusses a topic important from both the patients and practitioner’s point of view. Those of us who see large numbers of ophthalmic patient each day are well aware that making an accurate diagnosis of any retinal condition is virtually impossible without dilating the pupil. As the authors point out, there is ample evidence that pupillary dilation very rarely causes angle closure. Patients who develop angle closure after pharmacological pupil dilation are highly likely to develop the condition anyway and are usually within a setting where more rapid diagnosis and referral can be made.
The more puzzling aspect of this paper is why, when it is evident that all patients who need retinal examination should be dilated, is there a need for an editorial in a widely-read medical journal spelling this out?
For me the answer lies in the psyche of doctors and perhaps other practitioners. We all worry about harming our patients but the harm seems so much worse when it appears to be as a direct result of our action. We mentally balance the outcome of the situation where we could miss an important diagnosis but which will present at some nebulous time in the future (hopefully far enough away for the patient not to feel something was missed) against the apparent immediacy of causing a problem by pupil dilation. The fear we have is that the juxtaposition of action with consequence means the patient is more likely to ‘blame’ us for the event.
Patients with angle closure glaucoma are invariably treated by ophthalmologists and many of us have seen a number of patients who have been put into angle closure after pharmacological pupil dilation.
One of the first things we tell these patients is that they were going to get angle closure glaucoma anyway and the dilation merely brought this
event forward a little. Practitioners need to be aware that putting someone into angle closure is neither negligent nor blameworthy.
Conversely missing proliferative diabetic retinopathy or a retinal detachment because of failure to dilate the pupil is.
[e-RRE007]
Figure 1.10. A sample e-Rapid Response to an online Editorial
However, after careful reading of the e-Rapid Responses in our corpus, variability was observed in regard to purpose, degrees of spontaneity, article length and quality of argumentation. E-Rapid Responses ranged from being limited to single- topic, short and single-paragraphs to an 8-paragraph 4-topic well-argued 300- word article. Hence, it seemed that after an initial spontaneous response – frequently summarized in the initial paragraph– some BMJ readers, seemingly, have developed their arguments carefully and using the rhetorical strategies typically used in their academic community. Figure 1.11. illustrates a sample e- Rapid Response to an online research article.
Didgeridoo: Interesting but unconvincing
I congratulate Puhan and colleagues for their interesting study on a novel treatment for obstructive sleep apnoea (OSA)1. At first glance, the study appears to have good internal validity and is persuasive. However, closer inspection reveals that the evidence is weak for the following reasons.
Puhan selected non-obese participants (average BMI 25.8) with moderate OSA. The outcomes can be divided into subjective and objective measures. The Epworth sleepiness score is a subjective measure and showed the strongest positive effect in the trial. Those who use the Epworth regularly recognise that the score is dependent on many factors. Despite the title “randomised controlled trial”, this is not a
“placebo controlled” trial. As acknowledged by the authors, the participants in the Didgeridoo arm were highly motivated and it would be surprising indeed if the Epworth did not show a strong placebo effect.
The Apnoea Hypopnea Index (AHI) is an ‘objective’ outcome measure.
However the AHI is an imperfect measure of OSA severity. The halving of AHI from 22.3 to 11.6 at 4 months may seem impressive. However Puhan’s paper doesn’t give enough details on whether this change is due to change in weight or night to night variability caused by differences in sleep stages, amount of supine versus non-supine sleep, prior sleep deprivation, degree of nasal congestion, prior alcohol use, biological
variability and inter/ intra-scorer variability in marking apnoeas and hypopnoeas2.
The study is very small size and some readers may misinterpret the p value of 0.05 for change in AHI as indicating that there is only 5%
probability of the observed results being a chance finding. This is not so.
The p value gives a falsely exaggerated impression that the ‘data speaks for itself’3.
Using a Bayesian approach4: As there are no previous studies showing that upper airway muscle training would improve OSA, it is reasonable to assume a 90% pre-trial probability that the null hypothesis is correct (i.e. that Didgeridoo playing is no better than placebo). A p value of 0.05 approximates a Bayes Factor of 0.15. This gives a post-trial probability that the null hypothesis being correct as 57.4%. i.e. it is still more likely that the null hypothesis is correct. This highlights the importance of using the totality of evidence from other trials when interpreting p values in single trials5.
The burden of OSA in the community is large and many patients tolerate continuous positive airway pressure poorly. New approaches to treatment are necessary. However, the data in this trial is unconvincing that the Didgeridoo will emerge as a useful therapy, especially in those with obesity and more severe disease.
[e-RRRA018]
Figure 1.11. A sample e-Rapid Response to an online Research Article
This seems to imply that BMJresponders are to be well aware of the fact that, when publishing online, a world-wide audience and the online international community of BMJ members can read them, and that they can also react to the ideas they communicate online.
BMJ papers are commonly read. But, of those who read the e-paper, only some read the e-Rapid Responses posted. And, of those who read the whole online debate, only some will eventually decide to post a rapid response and engage in the e-debate. There might be several reasons for this fact; firstly, some readers might prefer to keep their opinions to themselves and not to go out onto the virtual arena, that is, to have their opinions and voices published at an international level.
Secondly, editorial writers tend to be experts in their field, acknowledged members of the discourse community, so, posting a response is a social step some
professionals & laymen, especially patients, may not dare to take. These fears seem not to have been shared by other members of the journal readership, who have posted several e-rapid responses with varying degrees of contribution quality.
From the observation of our corpus of e-Rapid Responses, the cognitive response elicited in the BMJ online reader might range from the reader’s emotional responses, judgments on the paper and recalling related research or relevant experiences among others. Letter-like sections have also been observed in some e- Rapid Responses.It is their rhetorical organization which is to our interest, they are approached in chapters 5 & 6.
BMJ Electronic rapid responses seem to be e-subgenres that are contributed within a particular context which imposes constraints on their realization and affects the e-responders choice of scientific medical content and rhetorical structure. Among the elements which may be relevant in the context, or situation, for the issuing of an e-RR by a BMJ responder, one may include the following:
▪ A worldwide readership, people who are capable of writing an opinion on the reviewed article, the e-RR, and their authors.
▪ The medical professionals all around the world whose work in hospitals and other medical centers can be affected by their words; and also those who are members of the BMJ medical discourse community.
▪ Research and knowledge experts in the area or field of interest, research groups, who can make observations on knowledge claims and methodological flaws, or comment on their process of reasoning.
▪ BMJ editorial board – who are gatekeepers and can gather an image of the e- responder– which can affect subsequent acceptance of paper submissions.
▪ The fact of being engaged in an online post-publication debate –which involves a certain amount of responsibility as a complementary evaluator, as an agent contributing to the validation of knowledge claims, the observation of methodological flaws and the prediction of editorial assertion effects among others.
▪ The time and space constraints imposed by the BMJ.
E-RRs appear to be an essential part of the open post-publication process in some e-journals and seem to be produced as the culmination of the online publication process constituting a strategic complementary stage of the review process.
However, there has been, to date, no study on this worldwide readership-produced e-subgenre. As such, a study of the e-RRs that contribute to the online BMJ can inform us on an electronic subgenre that fills a place somewhere between the publication of a paper, on the one hand, and the acknowledgment of its knowledge claims, on the other. A genre analysis of the electronic subgenre of e-RRs can shed light on the nature of this e-subgenre in terms of its discourse structure, its basic language parameters, and its place among different realizations of academic writing. The findings from such a study can be used to gain a wider view of genres in the field of medicine.
1.5 Objectives of the thesis
The objectives of this thesis are to study the language of electronic rapid responseson thebmj.com using the insights provided by Applied Linguistics. I
intend to observe similarities and differences across thebmj.com subcorpora and to describe them within the framework provided by Quantitative Applied Linguistics and Genre Analysis. Firstly, the aims of this thesis are to estimate the following language statistics of the subcorpora of BMJ e-rapid responses:
(i) the electronic activity elicited by BMJ papers in terms of rapid responses (ii) number of rapid responses per e-genre
(iii) number of words per e-rapid response type (iv) sentence length, and rapid response length (v) the most common words per rapid response type
Secondly, this research aims to identify the constituent elements of the rhetorical structure of e-Rapid Responses to editorials and research articles. In other words, my aim is to offer a corpus based description of thebmj.com e-RRs from a genre perspective. This implies the usage of quantitative applied linguistics for the characterization of the BMJ corpus in terms of length and most frequently used words in the corpus. Then, the genre analysis approach is employed to analize two corpora of BMJ e-RRs in terms of moves and strategies.
1.6 Research Questions
Medical professionals have interacted in many ways for centuries for the benefit of human health. The presence of the Internet has created new opportunities for interaction, and the myriad events that constitute the environment in which their communication takes place have expanded. Hence, our purpose in this dissertation is to contribute to a distinctive characterization of thebmj.com rapid responses as instances of online medical language, electronic English for Medicine
(Posteguillo, 2006). This thesis looks into a selection of electronic rapid responses to research articles and editorials in the theoretical framework provided by the perspectives of Applied Linguistics and Genre Analysis.
The specific research questions were:
▪ What is the average number of e-RRs per editorial and research article?
(Chapter four)
▪ What is the average number of words per e-RR type? (Chapter 4)
▪ What is the average sentence length per e-RR type? (Chapter 4)
▪ What is the average sentence number per e-RR type? (Chapter 4)
▪ What are the most frequent words used in e-RREs? (Chapter 4)
▪ What are the most frequent words used in e-RRRAs? (Chapter 4)
▪ What is the e-RRE structure in terms of moves and strategies? (Chapter 5)
▪ What is the e-RRRA structure in terms of moves and strategies? (Chapter 6)
▪ Is there an association between e-RR type and the range of purposes identified per e-RR type in the PPORDs? Are the differences found in the identified range of purposes per e-RR type significant? (Chapter 7)
▪ Is there an association between e-RR type and the identified structure of e- RRs in terms of moves? Are the differences found in the identified structures of e-RREs and e-RRRAs significant in terms of moves? (Chapter 7)
▪ Is there an association between e-RR type and the identified structure of e- RRs in terms of strategies? Are the differences found in the identified structures of e-RREs and e-RRRAs significant in terms of strategies? (Chapter 7)
